[Pathology] Atlas of Thymic Epithelial Neoplasms (part 3), Thymic Epithelial Neoplasms, Atlas of Mediastinal Pathology
Fig. 2.20 Spindle-cell thymoma can often undergo cystic degenerative
changes. In this particular example, the tumor is characterized by multiple
small cystic spaces, resulting in a reticular pattern of growth
Fig. 2.21 Spindle-cell thymoma with reticular and microcystic growth
patterns. Notice that the cells in the walls of the cysts are small and
spindled and there are scattered small lymphocytes admixed with the
cells and in the cystic lumina
Fig. 2.22 Spindle-cell thymoma with microcystic growth pattern.
Higher magnifi cation shows that the microcystic spaces correspond to
abortive perivascular spaces. Notice the central vessel in the larger cyst
on the left
Fig. 2.23 Another variation on the topic of microcystic thymoma
shows a dense spindle-cell proliferation dotted by numerous small
empty spaces suggestive of adipocytes on scanning magnification.
Notice the scattering of small lymphocytes admixed with the spindle
cells in the background
Fig. 2.24 Higher magnification from spindle-cell thymoma with
microcysts shows small empty lumina scattered among the spindle cells
that contain a rare small lymphocyte. The cells lack the features of adipocytes but may also not be recognized as perivascular spaces because
of the absence of a centrally located vessel
Fig. 2.25 Another aspect of spindle-cell thymoma with a microcystic
growth pattern shows evenly spaced small cystic cavities surrounded by
bland-appearing monotonous spindle-cell proliferation
Fig. 2.26 Higher magnification from microcystic spindle-cell thymoma
shows that the small cystic spaces contain small lymphocytes
Fig. 2.27 A spindle-cell thymoma with a macrocystic growth pattern
shows numerous small dilated perivascular spaces that have focally
coalesced to form larger, macrocystic spaces. The process can advance
to form a large multicystic mass that can be grossly confused for a multilocular thymic cyst
Fig. 2.28 A spindle-cell thymoma with a hemangiopericytoma-like
growth pattern is characterized by multiple branching vascular spaces
with open lumina surrounded by a dense spindle-cell population. On
cursory examination, tumors with these features can be mistaken for
solitary fibrous tumors or monophasic synovial sarcomas
Fig. 2.29 A different appearance of spindle-cell thymoma with a
hemangiopericytoma-like growth pattern shows dilated, anastomosing,
and branching vascular spaces lined by round to oval cells simulating
hemangiopericytoma
To be continue: [Pathology] Atlas of Thymic Epithelial Neoplasms (part 4)
Suggested Reading
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